scholarly journals Suture repair of patellar inferior pole fracture: Transosseous tunnel suture compared with anchor suture

2021 ◽  
Vol 22 (3) ◽  
Author(s):  
Wenzhou Huang ◽  
Tianlong Wu ◽  
Qiangqiang Wei ◽  
Longhai Peng ◽  
Xigao Cheng ◽  
...  
Keyword(s):  
Suture Repair ◽  
Inferior Pole ◽  
Anchor Suture

Bone suture anchor repair and functional outcome of a triceps tendon rupture, a rare clinical entity

2021 ◽  
Vol 14 (7) ◽  
pp. e241773
Author(s):  
Pieter Willem Johannes Lozekoot ◽  
Juul Jeanne Wilhelmus Tegels ◽  
Raoul van Vugt ◽  
Erik Robert de Loos
Keyword(s):  
Tendon Rupture ◽  
Suture Repair ◽  
Bone Anchor ◽  
Rare Injury ◽  
Accident And Emergency ◽  
Active Range Of Motion ◽  
Triceps Tendon Rupture ◽  
Elbow Function ◽  
Triceps Tendon ◽  
Anchor Suture

Triceps tendon rupture is rare and easily missed on presentation. A 58-year-old man was seen in our accident and emergency department with an inability to extend his right elbow against gravity after he fell. Ultrasound and MRI confirmed the suspected diagnosis of a traumatic triceps tendon rupture and excluded additional injuries. Surgical repair was carried out by a bone anchor suture reinsertion of the tendon to the olecranon. After 2 weeks of cast immobilisation, an early active range of motion (ROM) rehabilitation schedule was followed, resulting in excellent elbow function at 12 weeks postoperatively.In conclusion, it is important to suspect this rare injury and use additional studies to confirm the diagnosis of triceps tendon rupture. Also, good clinical outcome with regards to function can be achieved using bone anchor suture repair and an early active ROM rehabilitation schedule.

scholarly journals Outcome of Inferior Patellar Pole Avulsion Fractures

2016 ◽  
Vol 4 (2) ◽  
pp. 84
Author(s):  
Ruban Raj Joshi ◽  
Rajeev Dwivedi ◽  
Subin Byanjankar ◽  
Rahul Shrestha
Keyword(s):  
Internal Fixation ◽  
Hospital Stay ◽  
Open Reduction ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Patellar Ligament ◽  
Suture Repair ◽  
Avulsion Fractures ◽  
Inferior Pole ◽  
Tension Band Wire

Introduction: The optimal treatment for inferior pole patella avulsion fractures has still been a topic of debate. The options include (a) internal fixation of the pole fragment and (b) resection of the avulsed fragment and repair of the patellar ligament to the patella. We present the comparative outcomes for patients with displaced inferior pole patella treated by resection and transosseous Ethibond® Krackow suture repair of patellar ligament with open reduction and internal fixation with modified tension band wiring and circumferential wiring.   Methods: During a three year period between August 2013 and September 2016, twenty consecutive patients with distal pole fractures of the patella were prospectively enrolled in this study. These patients were divided into two groups. Group-T patients were treated with open reduction and internal fixation with modified tension band wire and  group-R patients by resection of the avulsed fragment and reattachment of the patellar ligament to the patella with #5 Ethibond®. Data entry and analysis was done by using SPSS version 20. Anatomical and functional outcome were compared.   Results: Consecutive 20 patients were treated either with resection lower patellar pole (n=10) or with open reduction internal fixation with tension band wiring (n=10). Demographics were matched in two groups. Group-T required a longer hospital stay (U=13.5, p=0.005). Complications were seen more often in Goup-T compared to Group-R (p=0.005). Group-R had better scores (Bostman score U=6, p=0.001; SFMA U=7.5, p=0.001) and range of movement (p<0.05).   Conclusion: Resection of the avulsed fragment and reattachment of the patellar ligament to the patella had better outcome according to the Bostman and SFMA dysfunction score, shorter hospital stay, and less complications as compared to open reduction and internal fixation with tension band wire and circumferential wiring.

scholarly journals Biomechanical Analysis of Patellar Tendon Repair With Knotless Suture Anchor Tape Versus Transosseous Suture

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712095480
Author(s):  
Patrick A. Massey ◽  
Mitchell Myers ◽  
Kaylan McClary ◽  
Jimmy Brown ◽  
R. Shane Barton ◽  
...  
Keyword(s):  
Bone Density ◽  
Patellar Tendon ◽  
Tendon Repair ◽  
Suture Repair ◽  
Suture Anchors ◽  
Gap Formation ◽  
Inferior Pole ◽  
Transosseous Suture ◽  
Load To Failure ◽  
Knotless Suture Anchor

Background: Patellar tendon ruptures have routinely been repaired with transosseous suture tunnels. The use of knotless suture anchors for repair has been suggested as an alternative. Purpose: To compare the load to failure and gap formation of patellar tendon repair at the inferior pole of the patella with knotless suture anchor tape versus transosseous sutures. A secondary objective was to investigate whether either technique shows an association between bone density and load to failure. Study Design: Controlled laboratory study. Methods: A total of 20 human tibias with attached patellar and quadriceps tendons were sharply incised at the bone-tendon junction at the inferior pole of the patella. A total of 10 tendons were repaired using 2 knotless suture anchors in the inferior pole of the patella and a single suture tape with 2 core sutures. The other 10 tendons were repaired using No. 2 suture passed through 3 transosseous tunnels. A distracting force was then applied through the suture in the quadriceps tendon. Gap distance through load cycling at the repair site and maximum load at repair failure were then measured. Bone density was measured using computed tomography scanning. Results: No difference was found in the mean load to failure of knotless patellar tendon repair versus transosseous suture repair (367.6 ± 112.2 vs 433.9 ± 99 N, respectively; P = .12). After 250 cycles, the mean repair site gap distance was 0.85 ± 0.45 mm for the knotless patellar tendon repair versus 2.94 ± 2.03 mm for the transosseous suture repair ( P = .03). A small correlation, although not statistically significant, was found between bone density and load to failure for the knotless tape repair ( R 2 = 0.228; P = .66). No correlation was found between bone density and load to failure for the transosseous repair ( R 2 = 0.086; P = .83). Conclusion: Suture tape repair with knotless anchors for repair of patellar tendon rupture has comparable load to failure with less gap formation than transosseous suture repair. There is a small correlation between bone density and failure load for knotless anchor repair, which may benefit from further investigation. Clinical Relevance: Using knotless suture anchors for patellar tendon rupture repair would allow for a smaller incision, less dissection, and likely shorter operating time.

scholarly journals Clinical Comparative Study on the Treatment of Inferior Pole Fractures of Patella by Double-row Anchor Suture Bridge Technique Combined with Kirschner Wire Tension Band Internal Fixation

2022 ◽  
Author(s):  
chen bingqian ◽  
zhengfei wang ◽  
zhi chen ◽  
xiaohong qu ◽  
xiaowen fang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Kirschner Wire ◽  
Operation Time ◽  
Tension Band ◽  
Double Row ◽  
Inferior Pole ◽  
Wire Tension ◽  
Suture Bridge ◽  
Suture Bridge Technique ◽  
Anchor Suture

Abstract Objective: To investigate the method, technique and clinical efficacy of double-row anchor suture bridge technique in the treatment of inferior pole fractures of patella, and to compare it with traditional Kirschner wire tension band internal fixation. Methods: General information A total of 62 patients were enrolled in this study, including 35 males and 27 females, aged 31-80 years old, with an average of (53.2±4) years old. All the patients were divided into two groups by a random double-blind method: Group A (double-row anchor suture bridge technique group) and Group B (Kirschner wire tension band internal fixation group), with 32 cases and 30 cases in each group, respectively. The two techniques were performed by the same group of doctors to fix the fracture respectively, and the intraoperative bleeding, operation time, incidence of postoperative complications, knee function score, etc., were compared between the two techniques. Results: Group A (double-row anchor suture bridge technique group): operation time 56-80min, with an average of (60±10) min; intraoperative blood loss 30-56ml, with an average of (43±10) ml. All incisions healed in one stage and stitches were removed after 2 weeks. No complications such as incision infection, flap necrosis and nerve injury occurred. The average healing time of the fracture was 12 weeks. At the last follow-up, the Bostman score was (28.5±3.3), and the excellent rate was 93.7%. Group B (Kirschner wire tension band internal fixation group): operation time 54-76min, with an average of (56±10) min; intraoperative blood loss 31-50ml, with an average of (43±80) ml. One patient developed delayed incision healing postoperatively. Four patients experienced Kirschner wire withdrawal, one of which was accompanied by infection. Two patients were found to have mild separation of distal fracture fragments, despite the fracture being fine. The average healing time of the fracture was 13 weeks. At the last follow-up, the Bostman score was (23.5±3.3), and the excellent rate was 86.7%. Conclusion: Double-row anchor suture bridge technique is applied to inferior pole fractures of patella by virtue of its various effects, such as the complete preservation of the inferior pole fragments during the operation, satisfactory fracture reduction, firm fixation, and meeting patients’ requirements for early postoperative ambulation. This technology is superior to traditional Kirschner wire tension band internal fixation owing to its advantages of no need to take out the internal fixation, firm fixation, no need to worry about Kirschner wire withdrawal and fewer complications, and its clinical efficacy satisfaction rate is also better than traditional surgical methods. In short, double-row anchor suture bridge technique is an ideal surgical procedure for the treatment of the inferior pole fracture of patella with safety, reliability and high satisfaction.

scholarly journals The ‘wave sign’ in hip arthroscopy: a systematic review of epidemiological factors, current diagnostic methods and treatment options

2020 ◽  
Author(s):  
Jason Derry Onggo ◽  
James Randolph Onggo ◽  
Mithun Nambiar ◽  
Andrew Duong ◽  
Olufemi R Ayeni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Protective Factor ◽  
Treatment Options ◽  
Arthroscopic Surgery ◽  
Classification Systems ◽  
Diagnostic Methods ◽  
Suture Repair ◽  
Significant Heterogeneity ◽  
Epidemiological Factors

ABSTRACT This study aims to present a systematic review and synthesized evidence on the epidemiological factors, diagnostic methods and treatment options available for this phenomenon. A multi-database search (OVID Medline, EMBASE and PubMed) was performed according to PRISMA guidelines on 18 June 2019. All studies of any study design discussing on the epidemiological factors, diagnostic methods, classification systems and treatment options of the wave sign were included. The Newcastle–Ottawa quality assessment tool was used to appraise articles. No quantitative analysis could be performed due to heterogeneous data reported; 11 studies with a total of 501 patients with the wave sign were included. Three studies examined risk factors for wave sign and concluded that cam lesions were most common. Other risk factors include alpha angle &gt;65° (OR=4.00, 95% CI: 1.26–12.71, P=0.02), male gender (OR 2.24, 95% CI: 1.09–4.62, P=0.03) and older age (OR=1.04, 95% CI: 1.01–1.07, P=0.03). Increased acetabular coverage in setting of concurrent cam lesions may be a protective factor. Wave signs most commonly occur at the anterior, superior and anterosuperior acetabulum. In terms of staging accuracy, the Haddad classification had the highest coefficients in intraclass correlation (k=0.81, 95% CI: 0.23–0.95, P=0.011), inter-observer reliability (k=0.88, 95% CI: 0.72–0.97, P&lt;0.001) and internal validity (k=0.89). One study investigated the utility of quantitative magnetic imaging for wave sign, concluding that significant heterogeneity in T1ρ and T2 values (P&lt;0.05) of acetabular cartilage is indicative of acetabular debonding. Four studies reported treatment techniques, including bridging suture repair, reverse microfracture with bubble decompression and microfracture with fibrin adhesive glue, with the latter reporting statistically significant improvements in modified Harris hip scores at 6-months (MD=19.2, P&lt;0.05), 12-months (MD=22.0, P&lt;0.05) and 28-months (MD=17.5, P&lt;0.001). No clinical studies were available for other treatment options. There is a scarcity of literature on the wave sign. Identifying at risk symptomatic patients is important to provide prompt diagnosis and treatment. Diagnostic techniques and operative options are still in early developmental stages. More research is needed to understand the natural history of wave sign lesions after arthroscopic surgery and whether intervention can improve long-term outcomes. Level IV, Systematic review of non-homogeneous studies.

scholarly journals Clinical Study of 107 Hospitalized Patients with Peritonsillar Abscess

2021 ◽  
Vol 04 (01) ◽  
pp. e11-e16
Author(s):  
Risa Wakisaka ◽  
Takumi Kumai ◽  
Kan Kishibe ◽  
Miki Takahara ◽  
Akihiro Katada ◽  
...  
Keyword(s):  
Clinical Study ◽  
Initial Treatment ◽  
Peritonsillar Abscess ◽  
Laryngeal Edema ◽  
Antibacterial Drugs ◽  
Inferior Pole ◽  
Duration Of Hospitalization ◽  
The Right ◽  
Superior Pole

AbstractWe conducted a retrospective analysis of the data of 107 cases of peritonsillar abscess treated at our hospital between January 2014 and December 2018. Data on age, sex, affected site, duration of hospitalization, method of drainage, presence/absence of laryngeal edema, antibacterial drugs used, and isolated bacteria were analyzed. Of the 107 patients, 71 were males and 36 were females; the median age was 44 years (range: 18–88 years).The left side was affected in 55 patients, the right side in 50 patients, and both sides in two patients. The abscess was localized in the superior pole in 71 patients, and in the inferior pole in 36 patients. Thirty-five patients had laryngeal edema, of which three underwent tracheotomy. Recurrence of the abscess was observed in 15 cases, with the recurrence developing within 3 months in 7 cases, and over a period of 3 years in 4 cases. As for the sensitivity of the causative bacteria to antibacterial drugs, 17% of the causative bacteria showed resistance to clindamycin, while none showed resistance to ampicillin/sulbactam (ABPC/SBT). We concluded that ABPC/SBT might be suitable for the initial treatment of peritonsillar abscess, and that we need to bear in mind the possibility of long-term recurrence.

scholarly journals All-Inside Double-Sided Suture Repair for Longitudinal Meniscal Tears

2021 ◽  
Author(s):  
Constant Foissey ◽  
Mathieu Thaunat ◽  
Jean-Marie Fayard
Keyword(s):  
Suture Repair ◽  
Meniscal Tears

scholarly journals Inferior Patella Dislocation due to Impaction in the Femoral Trochlea

2021 ◽  
pp. 89-92
Author(s):  
Ahmed Fadulelmola ◽  
Rob Gregory
Keyword(s):  
Closed Reduction ◽  
Early Mobilization ◽  
Patella Dislocation ◽  
Type Ii ◽  
Rare Presentation ◽  
Femoral Trochlea ◽  
Inferior Pole ◽  
Locked Knee ◽  
Inferior Dislocation ◽  
Superior Pole

Acute inferior dislocation of the patella is a rare presentation in trauma and orthopaedics. Type II is caused by direct upward force on the inferior pole of the patella when the knee is flexed impacting the superior pole osteophyte into the intercondylar notch. Impaction in the femoral trochlea is rarely reported. A 92-year-old lady presented with locked knee held in 85° of flexion with an abnormal knee contour. Radiographs demonstrated that the upper pole of the patella was impacted in the femoral trochlea with a fracture of a superior pole osteophyte. The extensor mechanism was intact. Closed reduction is achieved under strong opioid pain relief. The patient returned to her baseline knee function within 6 weeks. Closed reduction of an inferior patellar dislocation in elderly patients is aided by superior pole osteophyte fracture and facilitates early mobilization, and avoidance of general anaesthesia.

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